Pregnancy outcomes in severe polyhydramnios: no increase in risk in patients needing amnioreduction for maternal pain or respiratory distress

Kleine, Rodolpho Truffa; Bernardes, Lisandra Stein; Carvalho, Mariana Azevedo; Carvalho, Mário Henrique Burlacchini de; Krebs, Vera Lúcia Jornada; Francisco, Rossana Pulcineli Vieira

doi:10.3109/14767058.2016.1153060

Cited by 12 publications

(8 citation statements)

References 14 publications

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“…More frequently, especially in severe polyhydramnios group, we found fetal gastrointestinal malformations, which was comparable to the incidence described by other authors [4,11].…”

Section: Discussionsupporting

confidence: 78%

“…Interestingly, both in the whole studied population and in patients with severe polyhydramnios, we found lower prevalence of fetal central nervous system anomalies than in other studies [4,11,12]. More frequently, especially in severe polyhydramnios group, we found fetal gastrointestinal malformations, which was comparable to the incidence described by other authors [4,11].…”

Section: Discussionsupporting

confidence: 55%

“…In comparison with the results of other studies [4,11,12], we did not find any case of cardiac malformation, which was the most frequently diagnosed anomaly in foetuses of mother with polyhydramnios, described by Pri-Paz et al [4] and Boito et al [12].…”

Section: Discussionsupporting

confidence: 53%

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Polyhydramnios — frequency of congenital anomalies in relation to the value of the amniotic fluid index

Kornacki

Adamczyk²,

Wirstlein³

et al. 2017

Ginekol Pol

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Objectives: The aims of our study were to assess the correlation between the amniotic fluid index (AFI) value and the frequency and type of fetal anomalies. Material and methods:The material included 94 patients at the third trimester of pregnancy, 60 with mild polyhydramnios, 19 with moderate one, and 15 with severe one. Polyhydramnios was diagnosed if AFI was > 24 cm. All patients were divided into three groups based on the value of AFI: 1) mild polyhydramnios with AFI between 24.1 and 29.9 cm, 2) moderate polyhydramnios with AFI between 30-34.9 cm, and 3) severe polyhydramnios with AFI ≥ 35 cm. Results:The incidence of fetal malformations correlated significantly with the degree of polyhydramnios and was the highest in patients with severe polyhydramnios (53.3%, p = 0.002). Congenital malformations of the gastrointestinal tract were the most frequent fetal anomalies in the whole group of patients (5.3%). Trisomy 18 was the most frequent aneuploidy found in women with polyhydramnios (2.1%). Conclusions:1. The incidence of fetal congenital anomalies significantly increases with the degree of polyhydramnios, being most frequent in severe one and rather rare in a mild one. 2. Congenital malformations of the gastrointestinal tract were the most frequent anomalies in patients with polyhydramnios, especially in women with severe polyhydramnios.

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“…More frequently, especially in severe polyhydramnios group, we found fetal gastrointestinal malformations, which was comparable to the incidence described by other authors [4,11].…”

Section: Discussionsupporting

confidence: 78%

Section: Discussionsupporting

confidence: 55%

See 1 more Smart Citation

Polyhydramnios — frequency of congenital anomalies in relation to the value of the amniotic fluid index

Kornacki

Adamczyk²,

Wirstlein³

et al. 2017

Ginekol Pol

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“…Of 135 patients who were examined, 44 (32.6%) had respiratory distress and subsequently required amnioreduction. Based on the findings of this study and in accordance with the findings of the current study, the procedure caused no major complications (23).…”

Section: Discussionsupporting

confidence: 90%

“…Amnioreduction complications in patients suffered from polyhydramnios were explored in a study by Kleine et al (23). Of 135 patients who were examined, 44 (32.6%) had respiratory distress and subsequently required amnioreduction.…”

Section: Discussionmentioning

confidence: 99%

Maternal and Fetal Outcomes in Pregnant Women With Polyhydramnios Treated Based on Maternal and Fetal Distress and Preterm Delivery

Fardiazar¹,

Soltanpour²,

Ghatrehsamani³

2017

International Journal of Women’s Health and Reproduction Scienc

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IntroductionPolyhydramnios is a medical condition describing an excess of amniotic fluid in the amniotic sac which can be seen in 1%-2% of women. The overall prevalence of this condition is reported on 750 pregnancies. Patients suffered from polyhydramnios often referred to hospitals complaining about discomfort in the abdomen and respiratory distress. Abnormal magnitude of the uterus (compared to gestational age) along with difficulty touching embryonic organs and problems associated with fetus auscultation can be observed on physical examination. A definitive diagnosis is ultimately possible through ultrasound and by measuring the ammonic fluid index. Amniotic fluid index (AFI) more than 25 cm is considered as polyhydramnios, accordingly (1).Polyhydramnios may be associated with fetal and maternal complications such as respiratory distress, thromboembolism, preterm labor, atonic uterus, anemia, caesarean section, premature fetus, umbilical cord prolapse caused by the rupture of the membranes and fetal distress (2-4).Common treatment methods of polyhydramnios pregnancies include examination of maternal risk factors (diabetes, viral hepatitis, syphilis and other torch infections and addiction) and examination of fetal risk factors (hydrops fetalis, esophageal atresia, gastroschisis, anencephaly, diaphragmatic hernia, placental chorioangioma, severe anemia, heart problems and chromosomal abnormalities). In mild cases, simple control and follow-ups, continuous ultrasound and conservative treatment methods AbstractObjectives: Polyhydramnios is a condition that could be along with significant maternal, fetal and neonatal consequences. One of the most important complications of this condition is preterm labor and delivery of preterm neonates. Although in mild cases expectant conservative management is effective, in more severe cases, medications (such as indomethacin) and amnioreduction could be considered. Each one of these methods could be accompanied with complications. This study aims to examine the results of management of patients with polyhydramnios according to the fetal and maternal distress and preterm labor criteria. Materials and Methods: In this descriptive-analytic setting, 26 pregnant mothers with polyhydramnios (amniotic fluid index [AFI] more than 30) were managed according to the fetal and maternal distress and preterm labor criteria. In cases under 32 gestational weeks, indomethacin was used with an initial dose of 25 mg every 6 hours and a maximum dose of 2-3 mg/kg that was tapered when the AFI diminished. In refractory cases, the flowchart of fetal and maternal distress and preterm labor was employed. In pregnancies aged over 32 weeks, in case of maternal distress amnioreduction was performed, and in asymptomatic patients, cervical length, funneling, color Doppler and placental thickness were evaluated and in normal cases controlling was carried every 1-2 weeks and abnormal cases amnioreduction was carried out. Results: The mean age of studies patients was 28.12 ± 7.22 years and the mean pregnanc...

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Successful antenatal treatment of MAGED2‐related Bartter syndrome and review of treatment options and efficacy

Walsh,

Micke,

Elfman

et al. 2023

Prenatal Diagnosis

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A new form of transient antenatal Bartter syndrome (aBS) was recently identified that is associated with the X‐linked MAGED2 variant. Case reports demonstrate that this variant leads to severe polyhydramnios that may result in preterm birth or pregnancy loss. There is limited but promising evidence that amnioreductions may improve fetal outcomes in this rare condition. We report a woman with two affected pregnancies. In the first pregnancy, the patient was diagnosed with mild‐to‐moderate polyhydramnios in the second trimester that ultimately resulted in preterm labor and delivery at 25 weeks with fetal demise. Whole exome sequencing of the amniotic fluid sample resulted after the pregnancy loss and revealed a c.1337G>A MAGED2 variant that was considered diagnostically. The subsequent pregnancy was confirmed by chorionic villi sampling to also be affected by this variant. The pregnancy was managed with frequent ultrasounds and three amnioreductions that resulted in spontaneous vaginal delivery at 37 weeks and 6 days of a viable newborn with no evidence of overt electrolyte abnormalities suggesting complete resolution. A detailed review of the published cases of MAGED2‐related transient aBS is provided. Our review focuses on individuals who received antenatal treatment. A total of 31 unique cases of MAGED2‐related transient aBS were compiled. Amnioreduction was performed in 23 cases and in 18 cases no amnioreduction was performed. The average gestational age at delivery was significantly lower in cases without serial amnioreduction (28.7 vs. 30.71 weeks, p = 0.03). Neonatal mortality was seen in 5/18 cases without serial amnioreduction, and no mortality was observed in the cases with serial amnioreduction. In cases of second trimester severe polyhydramnios without identifiable cause, whole exome sequencing should be considered. Intensive ultrasound surveillance and serial amnioreduction is recommended for the management of MAGED2‐related transient aBS.

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Pregnancy outcomes in severe polyhydramnios: no increase in risk in patients needing amnioreduction for maternal pain or respiratory distress

Abstract: Amnioreduction performed to relieve maternal symptoms did not statistically increase the risk of pregnancy complications with severe polyhydramnios in single pregnancies.

Cited by 12 publications

References 14 publications

Polyhydramnios — frequency of congenital anomalies in relation to the value of the amniotic fluid index

Polyhydramnios — frequency of congenital anomalies in relation to the value of the amniotic fluid index

Maternal and Fetal Outcomes in Pregnant Women With Polyhydramnios Treated Based on Maternal and Fetal Distress and Preterm Delivery

Successful antenatal treatment of MAGED2‐related Bartter syndrome and review of treatment options and efficacy

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